Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, No.1120 Lianhua Road, Futian district, Shenzhen, 518036, Guangdong, China.
Institute of Obstetrics and Gynecology, Shenzhen Peking University-Hong Kong University of Science and Technology (PKU-HKUST) Medical Center, No.1120 Lianhua Road, Futian district, Shenzhen, 518036, Guangdong, China.
Sci Rep. 2024 Nov 18;14(1):28423. doi: 10.1038/s41598-024-79980-1.
The objective of this prospective study was to assess the efficacy of Hiporfin-photodynamic therapy (PDT) int the treatment of young women diagnosed with high-grade squamous intraepithelial lesions (HSIL) of the endocervical canal. This study included 14 patients aged 30 ± 4.2 years (range 21-37) with HSIL of the cervical canal, treated at our hospital from August 2021 to June 2023. Hiporfin (2 mg/kg) was administered intravenously and laser irradiation with a 630 nm wavelength was performed on the cervical canal and cervical surface 48-72 h later. All patients had been observed for at least 12 months. 64.3% (9/14) were nulliparous. The complete response (CR) rate of cervical canal involvement was 100.0% (14/14) at 3-6 months. Pre-PDT, all patients (14/14) tested positive for high-risk human papilloma virus (HR-HPV). The HPV eradication rate was 64.3% (9/14) at 3-6 months and 85.7% (12/14) at 12 months. No serious adverse effects were observed in patients during or after PDT. No recurrence was noted during the long-time follow-up. 6 patients who planned to get pregnant achieved 6 pregnancies including 1 spontaneous abortion, 2 term pregnancies, and 3 ongoing pregnancies. No fetal loss occurred due to cervical incompetence. Hiporfin-PDT may be a promising, fertility-preserving treatment for HSIL of the endocervical canal in young women.
本前瞻性研究旨在评估海姆泊芬光动力疗法（PDT）治疗年轻女性子宫颈管高级别鳞状上皮内病变（HSIL）的疗效。该研究纳入了 2021 年 8 月至 2023 年 6 月在我院接受治疗的 14 例年龄为 30±4.2 岁（21-37 岁）的子宫颈管 HSIL 患者。静脉内给予海姆泊芬（2mg/kg），48-72 小时后，用 630nm 波长激光照射子宫颈管和宫颈表面。所有患者均至少随访 12 个月。64.3%（9/14）为未产妇。3-6 个月时，子宫颈管受累的完全缓解（CR）率为 100.0%（14/14）。Pre-PDT 时，所有患者（14/14）均检测到高危型人乳头瘤病毒（HR-HPV）阳性。3-6 个月时，HPV 清除率为 64.3%（9/14），12 个月时为 85.7%（12/14）。PDT 期间或之后，患者均未观察到严重不良反应。长时间随访期间，无复发。6 例计划怀孕的患者共获得 6 例妊娠，包括 1 例自然流产、2 例足月妊娠和 3 例持续妊娠。无因宫颈机能不全导致的胎儿丢失。海姆泊芬-PDT 可能是一种有前途的、保留生育力的年轻女性子宫颈管 HSIL 治疗方法。
